Ameloblastic carcinoma of the jaws: Review of the literature

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Authors: Ramat Braimah, Chibuzo Uguru and Kizito Ndukwe
Date: July-December 2017
From: Journal of Dental and Allied Sciences(Vol. 6, Issue 2)
Publisher: Medknow Publications and Media Pvt. Ltd.
Document Type: Article
Length: 2,543 words
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Byline: Ramat. Braimah, Chibuzo. Uguru, Kizito. Ndukwe

Ameloblastic carcinoma is a rare odontogenic malignancy that combines the histological features of ameloblastoma with cytological atypia, even in the absence of metastases. The major prognostic factor is the clinical course of the disease which includes its aggressiveness, local destruction, and distant metastatic spread preferentially through hematologic route if neglected. Histologically, ameloblastic carcinoma retains the features of ameloblastic differentiation and exhibits cytological features of malignancy in a primary or recurrent tumor. Because it is a very rare lesion, it poses a great difficulty in diagnosis. En bloc removal with 1-2 cm of normal bone margin has been regarded as the safest surgical modality to ensure disease-free survival. Literature search was carried out using the Boolean operator 'And' between ameloblastoma and carcinoma on PubMed. Retrieved articles were extensively reviewed for epidemiology, etiology, diagnosis, treatment options, and prognosis of ameloblastic carcinoma.

Introduction

Ameloblastic carcinoma is a rare odontogenic tumor accounting for 1.5%-2.0% of all odontogenic tumors.[1] Only seventy cases have been reported in English literature from 1984 to 2011.[2] In 1982, the term 'ameloblastic carcinoma' was introduced by Elzay[3] to depict a malignant epithelial odontogenic tumor that histologically retains the features of ameloblastic differentiation and exhibits cytological features of malignancy in a primary or recurrent tumor. In the last WHO classification update published in 2005, it is defined 'as a rare odontogenic malignancy that combines the histological features of ameloblastoma with cytological atypia, even in the absence of metastases.'[2] It has characteristic histologic features and clinical behavior that requires a more aggressive surgery than that of ameloblastoma. Malignant ameloblastoma differs from ameloblastoma due to the presence of metastases, they both have the same benign histology.[4] Malignant ameloblastoma and ameloblastic carcinoma have been used interchangeably before in the past. However, it is now agreed that malignant ameloblastoma has the ability to metastasizes despite its benign histology in both the primary and the metastatic lesion.[5] On the other hand, ameloblastic carcinoma demonstrates histologic features of both ameloblastoma and carcinoma[3] with histologic features of malignancy found in both the primary and the metastases.[6]

Ordinarily, the tumor cells in ameloblastic carcinoma resemble the cells seen in ameloblastoma, however they show cytologic atypia. The tumor usually has direct extension, lymph node involvement, and metastasis to distant sites especially the lungs. Because it is a very rare lesion, it poses a great difficulty in diagnosis. Literature search was carried out using the Boolean operator 'And' between ameloblastoma and carcinoma on PubMed. Retrieved articles were extensively reviewed for epidemiology, etiology, diagnosis, treatment options, and prognosis of ameloblastic carcinoma.

Epidemiology

Ameloblastic carcinoma shows no age group predilection appears more frequently in men (two-third of cases) and involves more often the mandible (two-third of cases). According to Dhir et al .,[7] age range of the patients varies widely with a range of 51-84 years and a mean age of 53.5 years. No sex or race predilection has been noted;[8],[9] however, a male to female ratio ranging from 1.2:1 to 2.7:1[7],[10],[11] have been documented. Ramesh...

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Source Citation

Source Citation
Braimah, Ramat, et al. "Ameloblastic carcinoma of the jaws: Review of the literature." Journal of Dental and Allied Sciences, vol. 6, no. 2, 2017, p. 70. Accessed 6 Aug. 2020.
  

Gale Document Number: GALE|A578271465